Temperature Regulation in People with Down Syndrome

Key Points 

• How the body manages (regulates) body temperature is different in people with Down syndrome compared to people without Down syndrome.

• The difference in body temperature regulation in people with Down syndrome may be due to multiple factors including differences in blood flow to the skin, sweating, and, in some individuals, abnormal thyroid function.

• This difference may have implications for when a person with Down syndrome is exposed to hot or cold conditions or has an infection.

What do we know about body temperature of people with Down syndrome?

Our review of the medical literature found little information regarding the issue of body temperature regulation for people with Down syndrome. We found one article from Poland called Analysis of Body Surface Temperatures in People with Down Syndrome After General Rehabilitation Exercise . It compared body temperatures of people with Down syndrome to people without Down syndrome both at rest and after exercise. Some of their findings were:

• At rest, the surface body temperatures (temperatures at the skin) for men and women with Down syndrome were lower in all regions of the body compared to people without Down syndrome. 

• Fifteen minutes after exercise, the surface body temperatures of those without Down syndrome were higher than the temperatures before exercising. Their bodies appropriately shifted blood to the skin surface. This raises the temperature of the skin but cools off the body.

• In contrast, the surface body temperatures of those with Down syndrome were lower than the temperatures before exercising. Their bodies did not appropriately shift blood to the skin surface to cool off their bodies.

Sweating is another way our bodies regulate temperature. The surface of our skin cools when the water in sweat evaporates. In our experience, some (or many) people with Down syndrome sweat less than others. This can cause the body temperatures of those individuals to rise when they exercise, are in a warm room, or are outside in warm weather. We have an article called Warning Signs a Person with Down Syndrome is Getting Overheated that shares more information. The Down Syndrome Resource Foundation also shares information in their article Staying Safe During a Heatwave .

Some people with Down syndrome may be more sensitive to cold temperatures. They may need to dress more warmly or move to a warmer place sooner than someone else. We do see more acrocyanosis (blue discoloration of the hands and/or feet in response to cold) in people with Down syndrome. 

Another consideration for people with Down syndrome is the higher frequency of underactive thyroid (hypothyroidism) and overactive thyroid (hyperthyroidism). When these conditions are not treated, the body temperature may be lower if a person has hypothyroidism or higher if a person has hyperthyroidism. 

What are the implications of differences in temperature regulation?

The implications are not entirely clear. More research is needed. Therefore, we do not have "hard and fast" recommendations. A few things to consider: 

• People with Down syndrome may not be able to cool down in the typical fashion when the outside or room temperature is high and/or they are exercising. They may need to drink more cool water, take more breaks, or move to a cooler place. In a warm room, an elevated body temperature may not be a fever but may be related to a reduced ability to cool off.

• The difference in response to cold temperatures is even less clear. Wearing appropriate clothing in cold conditions to avoid complications from cold exposure is recommended.

• Fever response may not be a reliable measure of infection in some people with Down syndrome. 

• These observed differences compared to people without Down syndrome may be due to differences in the function of the autonomic nervous system (the part of the nervous system that reacts automatically without us having to think about it). 

Below are some articles for further reading regarding the autonomic nervous system in people with Down syndrome and other effects the difference in function may have: 

Hypertension and Hypotension (Adult Down Syndrome Center)

Vasovagal Syncope (Fainting) (Adult Down Syndrome Center)

Low Heart Rate and Blood Pressure (Adult Down Syndrome Center)

Urinary Retention (Adult Down Syndrome Center)

Down Syndrome and the Autonomic Nervous System, An Educational Review for the Anesthesiologist  (Pediatric Anesthesia)

Peripheral Blood Flow Regulation in Response to Sympathetic Stimulation in Individuals with Down Syndrome  (Artery Research)